Court of Appeal reject Davy Appeal

 The Court of Appeal delivered its decision on 7 Oct 09, rejecting the losing patient's appeal against District Court Judge Wager's decision, dismissing her claim at trial.  The lead decision was delivered by Justice Newnes, with whom the 2 other members of the Court agreed.

The case concerned alleged negligent medical care following Ms Davy undergoing knee replacement surgery in February 2004.  Ms Davy claimed that the public hospital, Sir Charles Gairdner Hospital, at which she was receiving post-operative care was negligent in failing to arrange more urgent review and intervention when she developed post-operative swelling and signs of infection, ultimately leading to her requiring major further surgery.  Interestingly, it was clear these infection issues did not arise until July 2004, so 5 months after her surgery.

The case overwhelmingly depended upon the issue of whether Ms Davy was to be believed as to her claimed attempts to contact the hospital's orthopaedic department to try to arrange her review, when her post-operative problems arose.

Judge Wager, the District Court judge was not convinced that Ms Davy's claims were reliable, largely because she found that Ms Davy's statements as to her attempts had varied over time and so in Judge Wager's view, were ultimately unreliable.  Judge Wager also noted that Ms Davy's GP's records did not suggest she had raised concerns in relation to her knee's condition, at a series of consultations after she claimed the problem had arisen (and after it was clear she had raised it with such GP).  On the other hand, it was clear that Ms Davy had phoned the orthopaedic department repeatedly over the relevant period (this was supported by her phone records).

Because of Judge Wager's rejection of Ms Davy's evidence (she found Ms Davy was "an honest, but unreliable historian"), she found the hospital were not negligent and there was not a need for the hospital to have arranged review and treatment of Ms Davy more urgently than occurred.

In a sense the appeal was a brave one.  It is well recognised principle that because an appeal court do not have the trial judge's advantage of seeing and hearing the manner in which witnesses give evidence, they are generally very slow to interfere with conclusions reached by a trial judge which are based on credit/truthfullness of a witness.

The above points were made clear by Justice Newnes, who found there was no merit in Ms Davy's attacks upon the trial judge's conclusions, which he confirmed were all open to her, even if contrary more favourable conclusions could have been made.

The case is again a good reminder of the difficulty of appeals when a trial judge has made adverse credit findings.  If a trial judge makes adverse findings about a plaintiff or their witness' evidence that are 'harsh' (perhaps because based on relatively minor errors etc) there is often little that can be done.  In a sense, in such cases, often an appeal is not really open.

It is also a very good reminder of the need to prepare for trial carefully and particularly to ensure all important witnesses are reminded of any previous statements or sworn evidence they may have given relevant to the facts of the case (which may have been given quite some time earlier).  This is absolutely critical in cases where the primary facts are the fundamental dispute (as here).  In this case, Ms Davy's evidence in the witness box diverged in some respects from statements she had made, particularly in answers to interrogatories.  

 

Personal Responsibility + Society's "Parenting" Role

Again, slightly off topic, though the broader consequences apply in a healthcare context.

Read with interest the Editorial in the Weekend Australian yesterday about the High Court's recent decision, with the less than informative name, C.A.L. No 14 Pty Ltd v Motor Accidents Insurance Board [2009] HCA 47.

The facts in the case were simple:

  1. the case concerned a claim of negligence against a Tasmanian hotel owner who handed back motorcycle keys lodged for safe-keeping to an insistent, belligerent patron who on leaving the pub was killed in a crash while showing a blood alcohol level of 0.253.
  2. A reading of 0.05 doubles the risk of a crash. At 0.08, the risk increases seven times. At 0.15, it is 25 times higher. Data was too scant to reliably calculate the risk at the level taken by the dead man.
  3. The man had drunk seven or eight cans of bourbon and cola between 5.15pm and 8.30pm. According to the judgment, the licensee told him he had had enough, that it was time to go home, and asked for his wife's phone number so that she could fetch him. The patron became agitated and said "If I want you to ring my f'ing' wife, I'd f'ing ask ya." The Licensee responded: "Whoo hang on, whoo, whoo, whoo, this is not, you know, don't go crook at me, this is not the arrangement that was made." Not having the wife's phone number, and not wanting to push the issue into further confrontation the licensee then gave the keys to the patron, after asking him three times if he was OK to drive

As has been widely reported (to the joy of many in the hotels industry), the High Court dismissed the claim against the publican, finding that no duty was owed to the driver that had been breached.

I accept the points made in the Australian, concerning the need for our society to accept individual choices and responsibilities.

On the other hand, when regard is had to the carnage each year on the roads due to alcohol, such 'individual responsibility" is hardly a promising or pro-active step to saving our bright young things from self-destruction on the road.  

Quite apart from the case of habitual heavy drinkers, who has not had opportunity to intervene when friends and loved ones might out of character have had a bit much to drink and required a tap on the shoulder and gentle insistence on a lift home?  It is a consequence of intoxication that it impairs judgement, not just behind the wheel but in getting behind the wheel in the first place.

The Court's decision seems to ignore the more complex issues behind public safety and the 'cost' of irresponsible alcohol sale, instead championing a self-determinant right to self-destruction (and potentially harm to innocent third parties on the road).

With respect there is much to be said of the comments in the Age, concerning this decision, which reach a very different conclusion to the Editorial in the Weekend Australian.

 

 

 

Miller - no duty owed by driver of stolen car

Although not concerning medical negligence cases, this case is of interest.

In this recent Court of Appeal decision (delivered 6 Nov 09), the Court found that a driver of a stolen car did not owe any duty of care to a passenger in such vehicle, who was aware of the fact the car was stolen.  The Court found the driver and passenger were engaged in "a joint criminal enterprise" and so no duty to take care arose.

Consequently, when the driver drove negligently colliding with a pole causing injury, the passenger, who at the time was a 16 year old girl, could not recover compensation for her injuries.  The passenger's injuries were serious and another passenger in the vehicle died from their injuries.  

The passenger was in a relationship in which she regarded the driver as akin to her 'uncle' and at trial evidence had been lead indicative of the driver's insistence that the passenger remain in the vehicle, when she had asked to be dropped off.  She had made this request when the driver, after initially driving safely, had started to speed and drive more dangerously.

I would have thought, with respect, that this final point would have removed any 'joint criminal enterprise" finding.  The passenger wished and requested to be let out of the car.  Had her request been followed, the joint illegal conduct (driving the stolen car) would have come to an end and she would not have been in the car at the time of the collision.  This point was recognised and commented upon by Buss JA.  I am surprised it wasn't emphasised more by the passenger.

Newnes JA, the other member of the Court based his conclusions on a view that:

"the respondent could not reasonably have expected that the appellant would drive the vehicle according to the ordinary standard of care

With respect, this seems to me to make a great leap.  Why was the fact the passenger's 'uncle' was driving a stolen car, necessarily reason to assume he would not drive safely and would put the occupants of the vehicle at risk by dangerously driving?  Also, what is the relevance to this of the fact, as stated above, that the passenger had requested to be let out as soon as the driver started to drive unsafely?  Doesn't this say anything of her expectations?

This decision reversed the trial judge's conclusion in favour of the passenger.

No doubt a shortcoming on my part, but with the greatest of respect, I can't understand the reasons for this conclusion.  McLure JA and Buss JA suggest the foundation for such view is that given the illegality of the enterprise it is not possible to ascertain an appropriate standard of care to be expected [R3] + [R81].    

Buss JA stated [R82]:

It is not feasible or appropriate for the law to endeavour to fix a standard of care by taking into account and evaluating the incidents of the criminal enterprise upon which the appellant and the respondent were jointly engaged

I for one am not sure why this wasn't feasible or appropriate.

Clearly a tough stance for our highest court. 

Ellis Argued - now we wait!

The High Court has now heard argument concerning this important (potentially ground breaking) decision and we are now in the Court's hands, for their decision.

The transcript of argument can be found here.  Although reading the transcript is not the same as hearing 1st hand, it seems Bret Walker SC had a torrid time, at least from some members of the Court!  

Interestingly, and this is close to a common concern in medical negligence claims, emphasis was placed by him on the capacity of the negligent party to know the information from which firmer conclusions about whether "A caused B" could be drawn.  It is often the case in medical negligence claims that when it is difficult to prove whether negligent medical care caused a particular bad outcome, that frustration is felt that the answer to such question would be known with certainty - if only the negligent care hadn't occurred (eg if the negligent failure to diagnose the breast cancer hadn't occur, we would have known whether there was or was not lymph node spread etc).

It seems to me that at least the more outspoken members of the Court during argument, expressed considerable scepticism at the approach of our Court of Appeal, in accepting that the Plaintiff's exposure to asbestos had contributed to his lung cancer, even though at least some evidence suggested it was 100 times more likely his cancer was a consequence of his smoking.

It also looks to me that the Court may be contemplating narrowing the traditional degree of contribution from negligent (or other tortious) conduct to an injury, for liability to arise.  

Traditionally, enough was shown if negligent action made a "material" contribution, which has often been accepted as met, when the contribution was more than negligible.  

in other words, if the Court accepted there were multiple causes for injury or illness, damages would be awarded if one of such causes was due to negligence (even if it was a minor or secondary cause - and even if it was likely the injury/illness may have occurred even if no such negligence occurred).  Further (and this has always been the difficult part to this, for me conceptually!), liability would then be for the entire consequences of the illness.  There would often not be a substantial reduction in the damages awarded, for the chances the same outcome would have occurred, even if the negligence had not occurred.

From my reading, several members of the Court were grappling, during argument, as to whether for a contribution to be 'material,' and so liability and damages follow, a greater extent of contribution should be required.

It will be interesting to see how the dynamics of argument translate into the Court's decision.

As a footnote, have to say I liked Justice Gummow's comment, when the submission was put that deciding whether a factor was or was not a cause of disease, was a matter of 'logic,' that:

"Logic itself is a house of many mansions"